Colon Cancer: Racial Disparities in Metastatic Disease

 James Murphy, M.D. Assistant Professor Department of Radiation Medicine and Applied Sciences Center for Advanced Radiotherapy Technologies  UC San Diego Moores Cancer Center 3855 Health Sciences Drive La Jolla, CA Interview with:
James Murphy, M.D.
Assistant Professor, Department of Radiation Medicine and Applied Sciences, Center for Advanced Radiotherapy Technologies ,UC San Diego Moores Cancer Center
La Jolla, CA 92093 What are the main findings of the study?

Dr. Murphy: This study evaluated racial disparity in metastatic colorectal cancer. In a large population-based cohort we found of over 11,000 patients we found that black patients were less likely to be seen in consultation by a cancer specialist, and were less likely to receive treatment with chemotherapy, surgery, or radiation. Furthermore, we found that this disparity in treatment accounted for a substantial portion of the race-based differences between black and white patients.  Were any of the findings unexpected?

Dr. Murphy: An abundance of research has found disparity in cancer treatment for minority patients, and another body of literature has identified race-based survival differences. The unexpected finding form our study relates to the observation that race-based differences in survival disappeared after accounting for the disparity in treatment.  What should clinicians and patients take away from your report?

Dr. Murphy: Multiple factors likely contribute to treatment disparity in minority populations, though the nature of this study makes it difficult to pinpoint a specific barrier. Potential causes of disparity include health-care access barriers, provider bias, patient mistrust, or communication breakdown. An awareness of racial disparity is important, though there is a substantial need for further research and intervention to reduce inequality in cancer. What recommendations do you have for future research as a result of this study?

Dr. Murphy: To effectively reduce cancer disparity further research should focus on identifying specific racial or ethnic barriers to cancer care. Overcoming these barriers will improve access to treatment and survival in metastatic colorectal cancer.


Racial Disparity in Consultation, Treatment, and the Impact on Survival in Metastatic Colorectal Cancer.

J Natl Cancer Inst. 2013 Nov 14. [Epub ahead of print]

Simpson DR, Martínez ME, Gupta S, Hattangadi-Gluth J, Mell LK, Heestand G, Fanta P, Ramamoorthy S, Le QT, Murphy JD.

Affiliations of authors: Center for Advanced Radiotherapy Technologies, Department of Radiation Medicine and Applied Science (DRS, JHG, LKM, JDM), Department of Family & Preventive Medicine (MEM), Division of Gastroenterology, Department of Internal Medicine (SG), Division of Hematology-Oncology (GH, PF), Department of Surgery (SR), Moores Cancer Center (DRS, MEM, SG, JHG, LKM, GH, PF, SR, JDM), University of California San Diego, La Jolla, California; San Diego Veterans Affairs Healthcare System, San Diego, California (SG); Department of Radiation Oncology, Stanford University, Stanford, California (QL).

Last Updated on March 19, 2014 by Marie Benz MD FAAD